Patient Confidentiality

Using “Bioethics on NBC’s ER: Betraying Trust or Providing Good Care? When Is It
Ok to Break Confidentiality?,” write a paper of 750-1,000 words in which you describe
your professional position regarding patient confidentiality.

1. Explain the ethical implications of a breach of confidentiality.
2. Provide ethical theories and/or ethical principles (from among those introduced in
   your readings) to substantiate your position.
3. Identify a reasonable alternative to address the dilemma presented in the article using
   a framework of ethical decision making presented in lecture or in your readings.
   Explain the significance of applying this framework.
4. Explain how an ethics committee might approach the dilemma using ethical theories,
   principles, and a collaborative approach to ethical decision making.

Patient Confidentiality
Introduction

Patient confidentiality is an important aspect of ethic, legal, and professional
requirement in heath care provision. However, in some circumstances it is difficult to adhere
to this guideline hence bringing implications to the health care provider. Fortunately, for
today’s healthcare professionals there are many ethical frameworks as well as committees to
guide and assist in the interpretations of circumstances leading to a breach of the trust
imparted to the patient. By using the article Bioethics on NBC’S ER: Betraying Trust or
Providing Good Care by Pamela Nathanson as an example, this paper analyzes the ethical
circumstances surrounding patient confidentiality.
Ethical implications of a breach of confidentiality
Observing patient confidentiality is an important ethical principle regarding provision
of health care and is stipulated in the Code of Professional Conduct (Hiroux, 2000).
Confidentiality is defined as the retaining of information entrusted to a person in the

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condition of special relationships such as patient-doctor. Confidentiality boosts a trusting
relationship, encourages transparent communication, and enables the health care provider to
establish rapport with his or her client. The patients are encouraged to be open up and give
honest information that will enable the health professional to make the best medical decisions
regarding their treatment if they speculate that their records will remain private (Nathanson,
2000).
Therefore patient confidentiality is based on trust and the healthcare professional are
under oath to keep in confidence the information they get from their clients (Hiroux, 2000).
The ethical implications of breach of this trust are many and include hefty costs used in
relation to legal charges for the health professional or institution. The patient has a right to
sue the health provider at the realization that this trust was breached (Hiroux, 2000).
Furthermore, breaching this trust has implications for the future business and duties of the
professional. Patients may chose not to revisit the health worker or institution, or those
attending will be uncomfortable giving the necessary information required to pass invaluable
medical decisions. Consequently, health service deterioration will ensue (Nathanson, 2000).
The health worker also loses the trust and respect from patients and these after being broken
are extremely difficult to rebuild. The professional may even be exempted from duty.
Ethical theories and/or ethical principles to substantiate your position
The position that patient information should always be held in privacy can be
explained by the deontological theory which is held in the view that a service provider should
be firmly implanted to his or her respective duty and obligations when evaluating an ethical
dilemma (Hiroux, 2000). This will enable the person to come up with consistent decisions
since they will adhere on the set duties. Therefore, going by the deontological theory, the

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health worker is obligated to the duty of respect to the patient by observing the patient’s right
to privacy.
A reasonable alternative to address the dilemma presented in the article using a framework of
ethical decision making and the significance of applying this framework.
The dilemma presented in the article shows a scenario in which the healthcare
professional is sometimes obligated by the law to break the confidentiality. Carol Hathaway
convinces two young patients reluctant to get into care that no matter what they reveal, she
will not disclose any information to anyone, including their parents. However, it turns out
that one client has cervical cancer and a sexually transmitted disease putting Hathaway in a
dilemma of whether to break the promise of confidentiality for the sake of ensuring
appropriate medical care and support for this young patient (Nathanson 2000). An alternative
way for Hathaway to handle the case was to transfer the information to the public health
authorities which should conduct the school for testing, counseling, and education for other
students without necessarily disclosing that Andrea has the STD. This would negatively
affect her psychological health and social interactions at school. Also, Andrea is too young
and need the support of her parents for the cancer treatment and care and therefore she should
have been counseled on the need to tell her parents. This is a case in which communal
concern supersedes the client’s entitlement to privacy. Confidentiality may be breached is
harm is foreseen for the patient and the society at large (Fry & Johnstone, 2002).
How an ethics committee might approach the dilemma using ethical theories, principles, and
a collaborative approach to ethical decision making
The ethical committee puts in mind that ethical considerations occur while observing
legal responsibilities. An ethics committee should take the side of Hathaway because her
informing the minor’s patient parent about her cancer condition would ensure that she got

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appropriate treatment early enough. Hathaway would not have been sure if Andrea would
disclose the information to her parents if she left that task to her. The committee should
support Hathaway’s decision to inform the school about the sex parties because this is at best
interest of the majority (Edge & Groves, 2006). The committee can apply the defense that
Hathaway did everything for the best interest of her patient and the community. It is a nurse’s
duty to act in the best interest of their patient and the public. If she did not breach the trust by
undertaking the actions, Hathaway would risk Andrea’ health and that of her schoolmates
which may have led to her being sued by Andrea’s parents for negligence as Andrea is a
minor.
In conclusion, health care professionals are subjected to various professional, legal,
and ethical duties which sometimes call for personal judgment to be utilized in a manner to
protect and help the clients as well as observe public health interests and wellness.
Consideration of such duties involves total adherence to patient confidentiality as there are
implications if not this is observed. However, there are some scenarios that allow for the
breach of this trust for the sake of protecting the health of the masses as well as providing the
most appropriate care for a vulnerable group.

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References:

Edge, R.S., Groves, J.,R. (2006). The ethics of healthcare. London: Thomson.
 Fry, T.S., & Johnstone, M.,J. (2002). Ethics in nursing practice. London: Wiley-Blackwell.
Hiroux, J.(2000). Basic principles: Individual freedom,& their justification in ethics: Theory
& Practice.
Nathanson, P., G. (2000). Bioethics on NBC’s ER: Betraying trust or providing good care.